Category Archives: Health Care

by James A. Bacon

As the COVID-19 virus continues to recede in Virginia, I’ve abandoned my day-to-day coverage of the numbers, but I think it’s still worthwhile to post periodic updates. The good news for Virginia as seen in the chart above, taken from the Virginia Department of Health COVID-19 dashboard, is that the number of confirmed cases and deaths reported daily continue to decline — even as the virus flares up in California, Texas, Florida and Arizona.

To what do we attribute Virginia’s good fortune? Has Governor Ralph Northam found the sweet spot in his policy mix of emergency measures? Are Virginians just better behaved — more likely  to wear masks and maintain social distance — than the citizens of other states? Does the Old Dominion have human settlement patterns — less density, fewer elevators, less mass transit — that lend themselves to the propagation of the disease? Do we look to demographic factors such as a smaller percentage of illegal immigrants living in overcrowded housing? Or, less likely but not inconceivable, is the population on a pathway to developing herd immunity?

Readers, weigh in.

— JAB

Here are three COVID-19 trends in Virginia worth watching:

1. The seven-day moving average of the test-positive rate ticked upwards yesterday for the first time in more than a month;
2. Hospital utilization by COVID-19 patients dipped to the lowest point since the Virginia Hospital and Healthcare Association began tracking the data in early April; and
3. It turns out that multisystem inflammatory syndrome was not much of a thing.

Positive-test rate. The percentage of COVID-19 tests confirming the presence of the virus hit a seven-day moving average of 5.9% yesterday, based on data published today on the Virginia Department of Health (VDH) COVID-19 dashboard. That’s up from 5.8% the previous day. That doesn’t sound like much, but the seven-day moving average smooths out daily fluctuations, and it reverses what had been a steady decline since May. This number is an indicator that the viral spread in the general population, which had been retreating steadily, may start picking back up. This metric bears watching.

Hospital utilization. On the other hand, there is no indication yet that the greater numbers of infected people is translating into more trips to the hospital. Continue reading →

Source: Virginia Department of Health COVID-19 dashboard

The bad news from recent COVID-19 statistics is that the numbers aren’t getting better. Virginia has hit a plateau in the number of confirmed cases, as seen in the chart above, which shows the seven-day moving average in the number of confirmed cases. To some degree, the tick upwards in COVID-19 cases may reflect increased testing. But it’s clear that the virus, which had been receding for a month, no longer is.

I’ve never worried overly much about the number of cases. The vast majority of cases cause no lasting harm. What matters is the number of hospitalizations and deaths. As it happens, the number of hospitalizations, which had undergone a month-long decline, also has hit a plateau, and the number of deaths has nudged noticeably higher than early June, as can be seen in the chart below. Continue reading →

Die, virus, die!

Three out of five of the 1,645 Virginians who have died from COVID-19 have been residents of long-term care facilities — one of the highest percentages of any state in the United States. There has been considerable speculation why. Vincent Mor, a research scientist with the Brown School of Public Health, has found that nursing-home staffing levels aren’t the issue. Neither is the source of funding, whether Medicaid or private insurance.

Mor argues that the size and location of long-term care facilities are the most decisive factors. Facilities most likely to have COVID-19 cases tend to be (1) located in larger urban areas with large populations of Hispanics and African-Americans, who are disproportionately likely to have the virus, and (2) the size of the facility, or, more specifically, the greater the number of employees coming and going.

“It’s all about the traffic,” he says in this PowerPoint presentation summarizing his research. “The bigger the building, the more people enter. … So, it’s NOT about the facility but the virus.”

I had never made these connections, and I think they are worth exploring here in Virginia. If the same pattern holds, it may influence how public health authorities prioritize the allocation of resources in the battle against the virus. Continue reading →

What makes Ralph run?

by James A. Bacon

A flood of COVID-19 test results were reported to the Virginia Department of Health (VDH) over the weekend — more than 45,000 tests — and the news is good. While 1,652 new cases were confirmed over Saturday and Sunday, the seven-day moving average of the percentage of people testing positive declined to 6.5%, which may be the lowest since VDH started reporting the data.

Meanwhile, we see continued declines in the number of people sick enough to warrant admittance to the hospital . The seven-day average of new hospitalizations per day now stands at 24. You have to go back to March in the earliest stages of the epidemic to find such a low number. Same story with the number of deaths.

The prevalence of the virus in the population is falling. Hospitalizations are falling. Intensive hospitalization as measured by ICU occupancy and ventilator use is falling. And deaths are falling.

Even the Virginia Mercury, an online publication with a progressive slant, is moved to explain in its COVID-19 coverage why the Northam administration isn’t opening up the economy more rapidly. After all, every criterion Governor Ralph Northam announced a month ago has been met: more testing, a falling rate of confirmed cases, and fewer hospitalization. Continue reading →